Carotid atherosclerosis is hardening of the arteries affecting the large arteries in the neck that supply blood to the brain.  This condition has been treated with medication, and sometimes with surgery for many decades.  Fortunately, our understanding of carotid atherosclerosis has grown rapidly in the past few decades, and so has our ability to evaluate and treat this condition effectively.  The dangerous thing about carotid atherosclerosis is that it obstructs blood flow to the brain and can cause blood clots to form and travel to the brain resulting in stroke. In fact, this condition is a major cause of stroke and threatened stroke or TIA (Transient Ischemic Attack).  The diagnosis is often made because one of these events occurs, or on the basis of simple physical examination in which a swishing noise, or bruit, may be heard when listening with a stethoscope over the site of partially obstructed flow.  Increasingly, patients are interested in having examinations performed to screen for carotid atherosclerosis, even if the physical examination is negative, because serious blockages can sometimes be present with no abnormal findings on the examination.  The ultrasound device is very useful in making the diagnosis, because with this machine, it is usually possible to visualize the blockage and also to determine the extent to which blood flow is obstructed by determining the velocity of blood flow past the point of obstruction.  A narrow spot in a river results in “rapids”.  Similarly, a narrow spot in a carotid artery will result in a faster rate of flow through that area.  Other tests are sometimes needed, such as angiograms, in which contrast material is injected to allow direct visualization of the inner channel of the arteries, allowing a more definitive diagnosis in some cases. 

Treatment includes medication like aspirin to diminish the chance that a blood clot will form.  Stronger medication like Plavix is sometimes used also to maximize protection.  Treatment of associated causative conditions (if present) including elevated cholesterol, high blood pressure, diabetes, cigarette smoking, and others must be included to prevent the condition from getting progressively worse.  If the obstruction is actually causing symptoms, or if the degree of obstruction is of sufficient severity (80 to 90% narrowing or worse), it is usually best to open up the blockage, even if no symptoms have occurred.  This is true because medications do not seem to give adequate protection against stroke when the blockage is severe.  Carotid artery stenting is now available and appears to be as effective as surgery with no greater risk.  This strategy allows the blockage to be corrected with a procedure done under local anesthesia during a single day in the hospital.  Capital Cardiovascular Specialists has been the leader in central Texas in this procedure.  Doctor Sam DeMaio of Capital Cardiovascular Specialists is the leading interventionalist in carotid stenting in the Austin area.  He is a national proctor for carotid stenting, authorized to train other specialists to perform this procedure.

Capital Cardiovascular Specialists recognizes the serious nature of carotid atherosclerosis and devotes great attention to the detection, treatment, and prevention of this serious medical problem.  When your physician listens over the neck with a stethoscope, detection of carotid atherosclerosis is the target.  Capital Cardiovascular Specialists have been involved in research studies to develop and test newer and better devices for correction of these dangerous obstructive lesions.